Sudden bursts of anger may trigger heart attacks, strokes or other cardiovascular events within two hours of a flare-up, a team of U.S. researchers suggest.

In a new study published in The European Heart Journal, researchers examined studies that spanned amore-than-18-year period from experts in the medical field.

The Harvard School of Public Health team found that cardiovascular events can be triggered by psychological stress, such as an angry outburst, which has “shown to increase heart rate and blood pressure, and vascular resistance.”

And people who are obese, smokers, or have a history of heart disease are more susceptible to cardiovascular events in any given hour, researchers say.

“The absolute impact of anger outbursts will be higher among individuals with known risk factors,” they write in the study.

The risk of an outburst leading to a heart attack or stroke is relatively low among people who aren’t at a high cardiovascular risk, the researchers say. However, the risk of heart attack or stroke can accumulate in people who have frequent anger outbursts.

Researchers say there would be an extra 158 heart attacks per 10,000 people among people who are at low risk of cardiovascular problems but who still have frequent anger outbursts.

Among people who are at high risk of cardiovascular problems, however, there would be an extra 675 heart attacks per 10,000 angry people.

While researchers emphasize that more research is needed to understand the link between anger and its health effects, they say certain medications and psychological interventions may help lower the risk of cardiovascular events triggered by rage-fuelled outbursts.